Innovamed Veins Sc

LBN: Innovamed Veins Sc
Innovamed Veins Sc is an health care organization with primary practice located at 2601 N Main St , Rockford IL 61103-3110. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Phlebology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Innovamed Veins Sc can be contacted via phone (815) 987-1802, or through Brito, Tracy C via phone (815) 987-1802.

Contact Information

Primary practice address
2601 N Main St Rockford IL 61103-3110
Phone: (815) 987-1802
Fax: (815) 987-1806
Website:
Map and Directions
Authorized official contact:
Name: Brito, Tracy C Doctor of Medicine (MD)
Phone: (815) 987-1802

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Phlebology 202K00000X 036074111 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036074111 Illinois

Profile Details

NPI number 1063652873
LBN Legal business name Innovamed Veins Sc
DBA Doing business as
Authorized official Brito, Tracy C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 6th, 2009
Last updated Jun 4th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1063652873 NPPES
Illinois MEDICAID 036074111

Popular Providers